P - 82502RE(�UEST FOR ELECTRICAL INSPECTION
1� ll L�- 5 8 9��; 8'21 Un�'�vers � A en�ue S ttelS 28, Saint Paul, Minnesota 55104
� (651) 642-0800 TTY/MRS 1-800-627-3529
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www. electri city. state. mn. us
Identify the work cavered by this request: eQ � i � ��
❑ NEW ❑ REMODEL ❑ ADDITION EPAIR - J I
GENERAL FE Outdoor Li tin Standard @$1
SERVICES I POWER SUPPLIES Traffic Si nal Standard �$5
0 to 400 Am re �$25 Su lemenial Fee (� $20
401 to 800 Am re �$50 Transfortners u to 10 KVA �$10
Above 800 Am re (� $75 Transformers over 10 KVA �$20
CIRCUITS / FEEDERS Transformer I Power Su for Si ns / Outline Li hUn �$5
0 to 200 Am ere �$5 ONE 8 TWO FAMILY DWELLINGS, EACH UNIT
Atwve 200 Am ere �$10 Includes the Service andlor Power Supply up to 500 Amperes, All
ALARM, COMMUNICATION, REMOTE CONTROL, SIGNALING Circuits and Two Inspection Trips Each Dwelli Unit �$80
CIRCUITS, CIFICUITS OF LESS THAN 50 VOLTS Additional Ins ion Tri s�$20
Each S stem Device or A aratus �$.50 Investi ative Fee
ADDITIONS TO THE GENERAL FEES Reins tion Fee (� $20
MULTIFAMILY DWELLINGS PER UNI TOTAL FEE
��.. �� i i..a� c� e�n oe. i i.,» (minimum total fee is $20) �C7.�b
OTHER ADDITI01
� RetrofR � $25 per Fixture
Pivot Irtigation Boom � $4(
ctured Hane Park Lots � S
� $30 per Hour
� $.31 per Mile
I inspecled the electricsl ir�slallation described herein on the dates s�ed:
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FOR OFFICE USE ONLY .
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Request Date: � Rough-in Inspection Required? ❑ Yes No Inspection Other Than Rough-In: ❑ Ready Now ❑ YVfll Call
J yp You must call the inspector when ready! Date Ready: `D 2p d
I ce�ify that I am the ICENSED CONTRACTOR ❑ COMPANY ❑ OWNER and hereby request inspection of the electrical work at
Job Address (Street, Box, or Route No.) City/ rP C�
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Company or Uy r Performing li
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EB-00001A-13 7/7/2000
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BOAND � ELECTRICITY COPY
Number
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INSTRUCTIONB ON BACK OF YELLOW COPY